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POLITICO 44

Rep. Tom Price, an orthopedic surgeon and chairman of the House Republican Study Committee, donned his figurative white coat last Wednesday and issued a grim prognosis about the Democrats’ health plan. “In the Hippocratic Oath I took to become a physician, the phrase ‘I will keep [my patients] from harm and injustice ...’ remains dear to me,” Price blasted in an e-mail, “not only as a physician but now as a member of Congress.”

“I have devoted my life to keeping my patients healthy and safe, and now I apply those same principles to my constituents in Georgia’s 6th District. With that said, the Democrats’ current plan in the U.S. House is detrimental to America’s well-being.”

The not-so-implicit message: When it comes to health care reform, doctors know best.

But do they?

Some experts — and even some doctor-politicians — say that having an M.D. after your name doesn’t necessarily mean that you’re smarter than the next member of Congress on health care reform. And conflating a medical background with legislative duties can be problematic.

“I don’t think it’s very important,” says Rep. Ron Paul (R-Texas), an obstetrician. “Doctors are like people, and they come from all stripes. And if you brought those 16 doctors in here and sat down and listened to our conversation, I don’t think you’d say, ‘You know, that guy makes a lot of sense.’ They are no better than their political philosophies.”

Howard Dean, a physician and former Vermont governor and Democratic National Committee chairman, says he “sadly” agrees that when it comes to his medical colleagues in the Congress, “like everyone else, they seem to vote their ideology more than their profession.” Dean adds that doctors often do not have finance or executive experience, which would provide valuable wisdom for this debate.

There are currently 16 physicians in Congress: 14 in the House (plus two dentists) and two in the Senate. That adds up to more members with medical degrees than at any time during the decades-long modern health care debate.

On the Senate side, Republican Conference Chairman Lamar Alexander of Tennessee has put his two docs to work. Sens. Tom Coburn (R-Okla.) and John Barrasso (R-Wyo.) have taken to the Web with a weekly online video program called “The Senate Doctors Show.” The videos, which run 25 minutes or so in length, are posted on the Senate Republican Conference website.

But the medicos on Capitol Hill must decide how much they should assert their reputations. And the question has parallels to other congressional debates. During the Iraq war debate, special deference inside and outside the Beltway was paid to lawmakers with military backgrounds. Sens. Jack Reed (D-R.I.) and John McCain (R-Ariz.) and Rep. John Murtha (D-Pa.) became ascendant voices in the Senate and the House. Similarly, when the topic is judicial, those with law degrees rise to the top of the conversation. But Darrell West, director of governance studies at the Brookings Institution, thinks the same does not, and should not, apply to those with medical backgrounds.

“Everybody thinks they know something about health care, because we all go to doctors,” says West. “Not everybody has practiced in a courtroom or been on a battlefield, so the expertise in those areas counts for more than what is true with physicians.”

In some measure, the question of a doctor’s credibility is a debate about the debate itself. Is health care reform, at its root, really about medicine? Or is it about economics? Or social justice? Or all of the above?

“This is really a bill that is not about health care,” says former Republican Rep. Mickey Edwards, a lecturer at Princeton University.

“It is about what role should the government play in taking care of a portion of Americans that don’t have health insurance, and what price should we be willing to pay to meet that need.”

Readers' Comments (35)

Well, I for one, am not impressed by the Congress Dr's. And lets take Price & the Ga. Dr's, for an example. All of these people were "supposed" leaders in Georgia. And look where we are. One of the very bottom states in providing for its citizens. & the current rankings. We do not fund the SCHIP program nor the medicaid program. We can't buy a decent insurance plan across state lines. We ration by lack of access. Ga. and most of the south , WHere were these "noble" leaders, in promoting services in out own state?

These are simple big business (that has obviously failed) representatives. And they do no service in their combative attitudes & verbage. I have listened to the house & senate hearings & it is shameful the way most of the Dr's act & talk. Of course, must remember that Ga. is a red state. IE "A good old boy state"

You will not find many nurses that support their attitudes. Guess why. We have seen their actions from inside the healthcare system. And as to Obama's remark about taking out tonsils instead of looking for other treatments, first! Well, he is right on. I never worked with any of these guys , but I know their kind. Forty two plus yrs in the Operating Room, has shown me a side of many Dr's. That I do not impress me. Are their still a few good guys out there? Yes, but boy are they hard to find! And this crowd has their own vested interests at heart.

Dr's are the drivers of all orders, treatments, etc. You will never change the healthcare delivery system, until we have Dr's. who are true leaders and really care about what they do.

In addition, Americans should realize that only 20-25% or fewer physicians are members of the American Medical Association (AMA). It represents only a small minority of physicians. So when Democrats and Obama are making deals with the AMA, they are not dealing with the mainstream physicians of the country.

Many family physicians are morons. When I talk to mine, I wonder sometimes how he made his license. The only reason I need this guy , is for a prescription for what ever ails me at the time. He acts like it was a bad day in July when they discovered antibiotics. Although every ailment I ever had was cured with antibiotics. So we sparr and beat around the bush until he finally gets his prescription pad out and starts writing. How I can hurry up his mind ? , only when I threaten him eventually with a specialist. Then his ears start perking up. Obama wants to take that away from me and many more citizens. All the specialists like Internal medicin and others are all good doctors. Obama wants my family physician be mostly the only doctor for me. And should I need more than my family physician, as far as Dr. Emauel and Obama are concerned, I should look me for a hospice, or better yet... do an Indian burial. .. Good luck America.

I want to know===========under Obama health plan, if a 75 year old person and a 17 year old illegal mexican both show up at the health clinic for care which one will be turned away?????????? my guess would be the 75 year old who was born in the USA, worked all their life and paid into medicare for years and years. This will be Obama rationing health care.

Some experts — and even some doctor-politicians — say that having an M.D. after your name doesn’t necessarily mean that you’re smarter than the next member of Congress on health care reform. And conflating a medical background with legislative duties can be problematic.

As opposed to the lawyer-politicians who are supposed to be smarter at writing laws???? Too funny!!!!

Republicans are always easy to understand: just follow the money...The giant, behemoth insurance companies pay these guys well to do their bidding. Republicans are only "pro-life" until the baby is born, after that they lose interest.

want to know===========under Obama health plan, if a 75 year old person and a 17 year old illegal mexican both show up at the health clinic for care which one will be turned away??????????

Ignorance....why focus on such a hypothetical..that would even account for .....001% of the cases. Stay focused on the pre- and post- natal care that will actually save lives. Your are "pro-life" aren't you? Oh that's right, Republicans are only "pro-life" until the baby is born, after that they lose interest.

Or... you could look at the voting record and reputation of the one M.D. Congressman Ron Paul. He votes what is "Constitutional"... I know that's not the popular thing to do anymore, but it IS the legal, ethical, and responsible thing to do. Look at ALL the medical issues put in front of the Congress for vote (stem cell research etc.) and then compare the votes... Ron Paul votes WITH the Constitution and believes IF the MAJORITY of the American people want to change the Constitution... do it according TO the Constituion (whether he agrees with it or not... if it's changed properly, legally and Constituionally... he will support enforcement).

Physicians are not experts on Health Care Reform, as medical students point out. But then neither is Congress. Congress is too busy taking money from the Medical Insurance lobby representing people who's salaries and bonuses exceed $14 million with not a dime going to Health Care. They don't represent their people. They represent money and those who have it. Physicians only care about who is paying and how much! If physicians really cared they would not send their patients to the ER on nights and weekends to wait for 6 hours because they are too lazy too see them. An ER visit I made cost over $6,000! That is a little over 1/4 of the average income for 50% of American taxpayers!

Doctors should have an option similar to those found in auto insurance , that being to allow the doctor to declare someone a total loss , part them out , and retain the proceeds of sales of the parts as compensation .

Ron Paul represents less than the neocon right-wing which has taken over Congress. The only part of the Constitution they think they know is the 2nd Amendment. Too bad they don't start with the 1st Amendment! They haven't a clue what that means!

robrob79 Party: NA Reply #4 Jul. 28, 2009 - 9:39 AM ESTI want to know===========under Obama health plan, if a 75 year old person and a 17 year old illegal mexican both show up at the health clinic for care which one will be turned away?????????? my guess would be the 75 year old who was born in the USA, worked all their life and paid into medicare for years and years. This will be Obama rationing health care.

Has nothing to do with citizenship, but with age. Obama feels the older crowd won't vote for him anyhow. Plust he never learned really in my opinion to care for the elderly, he never was around them, and didn't in my opinion have close ties, besides in my opinion getting supported. A far cry from being close family.

Will Obama's bill include dental care? Eye care and glasses. I haven't heard anything. Then will he pay for abortions? All other industrial countries have dental care. Don't even start with a half hap health care program. We have that now.

“In the Hippocratic Oath I took to become a physician, the phrase ‘I will keep [my patients] from harm and injustice ...’ remains dear to me, not only as a physician but now as a member of Congress.” - Tom Price

Tom, when you blow your brains out to comply with this belief- can I watch? Take Coburn and Paul out with you...thanks!

Ignorance....why focus on such a hypothetical..that would even account for .....001% of the cases. Stay focused on the pre- and post- natal care that will actually save lives. Your are "pro-life" aren't you? Oh that's right, Republicans are only "pro-life" until the baby is born, after that they lose interest.

The lie of the left (People are denied healthcare)

Hypothetical? Rationing and end of life counseling are fact in countries that have socialized medicine.

The 75 year old will not get a hip or knee replacement, they will be given a walker or cane and told to live with it, that is fact.

A child who may need expensive chemo (experimental) but has shown promising results in testing will be denied, so that someone else may receive treatment based on odds and cost.

Before you spout off learn the facts, this is not a right wing issue, it is what is in the best interest of the majority of Americans.

Helen Carter The Guardian, Monday 2 June 2008 Article historyThe husband of a woman who died of cancer but was denied free NHS treatment because the couple chose to pay privately from their savings for a drug to prolong her life yesterday urged the government to change its guidelines.

Linda O'Boyle, 64, who had bowel cancer, is believed to be the first person to die after fighting for the right for top-up NHS treatment alongside privately purchased cancer medicine - so-called co-payment. Six other patients are launching a legal action to allow NHS patients to top up their care with private drugs. Three of the cases, involving women with liver and bowel cancer, are expected to prompt a judicial review of the government's ban on co-payment.

The health secretary, Alan Johnson, claims co-payment would create a two-tier NHS with preferential treatment for patients who could afford the extra drugs. Last year he issued guidance to NHS trusts, ordering them not to permit patients to pay for additional medicines. Yesterday Brian O'Boyle urged the government to alter guidelines which state that patients who buy drugs privately should pay for NHS treatment. The couple paid £11,000 for an eight-week course of the drug Cetuximab after NHS consultants told them they had run out of options. Linda O'Boyle died on March 26.

Brian O'Boyle, 74, of Billericay, Essex, said: "It's not the NHS, it is the government guidelines that are restrictive and the PCTs [primary care trusts] interpret these in various ways - it is a lottery. I think every drug should be available to all of us if there's a need for that drug."

His wife, who had worked for the NHS as an assistant occupational therapist, was diagnosed with cancer in December 2006. She was operated on in January 2007 for bowel cancer, which had spread to her stomach lining. A mother of three children and four grandchildren, she had six weeks of chemotherapy and further treatment until September, when doctors told her there was little more they could do.

However, her consultant suggested a new drug called Cetuximab which could extend her life. He applied for permission to try the drug, which has not received approval from the National Institute for Health and Clinical Excellence, but was turned down. Her husband said: "I said to the consultant, I wanted to pay for this ... She knew and I knew she was not going to get better but if there was the possibility of spending more time with her four young grandchildren, to see them grow up a bit more, we wanted to take it."

The couple spent £11,000 on the course of drugs as well as the treatment she was previously receiving free from Southend University Hospital NHS foundation trust, which withdrew its funding. The trust said in a statement: "A patient can choose whether to continue with the treatment available under the NHS or opt to go privately for a different treatment regime. It is explained to the patient that they can either have their treatment under the NHS or privately, but not both or in parallel." www.guardian.co.uk/society/2008/jun/02/nhs.health

Ignorance....why focus on such a hypothetical..that would even account for .....001% of the cases. Stay focused on the pre- and post- natal care that will actually save lives. Your are "pro-life" aren't you? Oh that's right, Republicans are only "pro-life" until the baby is born, after that they lose interest.

The lie of the left (People are denied healthcare)

Hypothetical? Rationing and end of life counseling are fact in countries that have socialized medicine.

The 75 year old will not get a hip or knee replacement, they will be given a walker or cane and told to live with it, that is fact.

A child who may need expensive chemo (experimental) but has shown promising results in testing will be denied, so that someone else may receive treatment based on odds and cost.

Before you spout off learn the facts, this is not a right wing issue, it is what is in the best interest of the majority of Americans.

Helen Carter The Guardian, Monday 2 June 2008 Article historyThe husband of a woman who died of cancer but was denied free NHS treatment because the couple chose to pay privately from their savings for a drug to prolong her life yesterday urged the government to change its guidelines.

Linda O'Boyle, 64, who had bowel cancer, is believed to be the first person to die after fighting for the right for top-up NHS treatment alongside privately purchased cancer medicine - so-called co-payment. Six other patients are launching a legal action to allow NHS patients to top up their care with private drugs. Three of the cases, involving women with liver and bowel cancer, are expected to prompt a judicial review of the government's ban on co-payment.

The health secretary, Alan Johnson, claims co-payment would create a two-tier NHS with preferential treatment for patients who could afford the extra drugs. Last year he issued guidance to NHS trusts, ordering them not to permit patients to pay for additional medicines. Yesterday Brian O'Boyle urged the government to alter guidelines which state that patients who buy drugs privately should pay for NHS treatment. The couple paid £11,000 for an eight-week course of the drug Cetuximab after NHS consultants told them they had run out of options. Linda O'Boyle died on March 26.

Brian O'Boyle, 74, of Billericay, Essex, said: "It's not the NHS, it is the government guidelines that are restrictive and the PCTs [primary care trusts] interpret these in various ways - it is a lottery. I think every drug should be available to all of us if there's a need for that drug."

His wife, who had worked for the NHS as an assistant occupational therapist, was diagnosed with cancer in December 2006. She was operated on in January 2007 for bowel cancer, which had spread to her stomach lining. A mother of three children and four grandchildren, she had six weeks of chemotherapy and further treatment until September, when doctors told her there was little more they could do.

However, her consultant suggested a new drug called Cetuximab which could extend her life. He applied for permission to try the drug, which has not received approval from the National Institute for Health and Clinical Excellence, but was turned down. Her husband said: "I said to the consultant, I wanted to pay for this ... She knew and I knew she was not going to get better but if there was the possibility of spending more time with her four young grandchildren, to see them grow up a bit more, we wanted to take it."

The couple spent £11,000 on the course of drugs as well as the treatment she was previously receiving free from Southend University Hospital NHS foundation trust, which withdrew its funding. The trust said in a statement: "A patient can choose whether to continue with the treatment available under the NHS or opt to go privately for a different treatment regime. It is explained to the patient that they can either have their treatment under the NHS or privately, but not both or in parallel." www.guardian.co.uk/society/2008/jun/02/nhs.health

Thousands of kidney cancer patients are likely to lose out on life-prolonging drugs.

The NHS rationing body, NICE, has confirmed a ban on three out of four new treatments.

It has reversed its position on just one, Sutent, which will now be allowed for patients with advanced cancer. But campaigners who fought NICE's original blanket ban said this was not enough. They said some patients with heart problems cannot tolerate Sutent.

Kate Spall, head of the Pamela Northcott Fund campaign group, said the ruling meant that fewer than half of newly diagnosed patients would be eligible for therapy.

She added: 'Families will be denied time together and doctors will be unable to give patients the best treatment.'

Campaigners are angry that NICE appears to have ignored new official guidelines widening access to life-prolonging drugs.

Sutent, also known as sunitinib, can double the life expectancy of patients, to 28 months, compared with standard interferon treatment. It costs around £24,000 a year.

The rejected drugs - bevacizumab (Avastin), sorafenib (Nexavar) and temsirolimus (Torisel) - have similar costs and are used in other countries.

Dr Thomas Powles, Clinical Senior Lecturer, at Barts and The London NHS Trust, said the 'one fits all' policy would disadvantage many of the 7,000 patients diagnosed each year with kidney cancer.

He said: 'This one dimensional approach will leave some patients without potentially beneficial treatments, indeed some patients will not be eligible for any effective treatments whatsoever.'

Stella Pendleton, executive director of the Rarer Cancers Forum, said: 'This decision contradicts the spirit of the recommendations made by Professor Mike Richards on improving access to medicines for NHS patients, and highlights flaws in the current system for appraising drugs. www.liberty-page.com/issues/healthcare/ukkidney.html